Agape Hospice & Palliative Care NW, LLC

Primary specialty

Community Based Hospice Care AgencyTaxonomy code 251G00000X

Legal business name

AGAPE HOSPICE & PALLIATIVE CARE NW, LLC

Doing business as

Agape Hospice NW

Practice address

10200 SW Nimbus Ave Ste G5
Portland, OR 97223-4339

Phone

(503) 746-4740

Fax

(503) 746-4740

NPI assigned

Sep 23, 2021

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Larisa Mihaela Louka

Title

Ceo

Phone

(503) 628-9595

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Agape Hospice NW Doing business as

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in OR

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1790456374. Details of each certification follow.

• CCN 381577 Hospice · Active · Details

Hospice certification: CCN 381577

Legal name

AGAPE HOSPICE & PALLIATIVE CARE NW LLC

Doing business as

AGAPE HOSPICE NW

Certification status

Active

Provider type (POS)

Hospice

Participating since

Jun 20, 2022

Last certification

Jun 20, 2022

Ownership / control type

Proprietary - Partnership

Organization structure

LLCProprietary

Incorporated

Aug 15, 2019 in OR

Enrollment address

10163 SE Sunnyside Rd
Ste 340
Clackamas, OR 97015-5716

Listed as

Agape Hospice NWCCN 381577 · All quality measures

Ownership

For-Profit

Certified

Jun 20, 2022

Medicare certification status

ActiveFrom the Provider of Services file

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

All disclosed owners & managing parties 5

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

• Jefferson Tiu Loa, M.D.

  • Internal Medicine Physician
  • Corvallis, OR
  • NPI 1336304773

  Contracted Managing Employee

  CMS ownership

Affiliated clinicians 10

Clinicians who list this facility as an affiliation in Medicare Care Compare.

• Jacqueline M Eriksen, M.D.

  • Family Medicine Physician
  • McMinnville, OR
  • NPI 1588618458

  Hospice

  Care Compare affiliation
• Thomas D Gilberts, MD

  • Internal Medicine Physician
  • Beaverton, OR
  • NPI 1841214236

  Hospice

  Care Compare affiliation
• Richard K Kimani, M.D.

  • Internal Medicine Physician
  • McMinnville, OR
  • NPI 1417951849

  Hospice

  Care Compare affiliation
• David P Larson, MD

  • Internal Medicine Physician
  • Beaverton, OR
  • NPI 1992798599

  Hospice

  Care Compare affiliation
• Jefferson Tiu Loa, M.D.

  • Internal Medicine Physician
  • Corvallis, OR
  • NPI 1336304773

  Hospice

  Care Compare affiliation
• Anthony Pham, M.D.

  • Hematology & Oncology Physician
  • Tigard, OR
  • NPI 1790913994

  Hospice

  Care Compare affiliation
• Ian Denison Schnadig, M.D.

  • Hematology & Oncology Physician
  • Tualatin, OR
  • NPI 1467664839

  Hospice

  Care Compare affiliation
• David Wayne Windler, M.D.

  • Hospice and Palliative Medicine (Internal Medicine) Physician
  • Tigard, OR
  • NPI 1538556949
  Care Compare affiliation
• Zafar Ms Khan, MD

  • Family Medicine Physician
  • North Miami Beach, FL
  • NPI 1154399517

  Hospice

  Care Compare affiliation
• Sanjivan Singh Kohli, MD

  • Pulmonary Disease Physician
  • San Juan Capistrano, CA
  • NPI 1801129663

  Hospice

  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1632355200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1696291200000",
    "number": "1790456374",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10200 SW NIMBUS AVE STE G5",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972234339",
            "telephone_number": "503-628-9595",
            "fax_number": "503-477-6547"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10200 SW NIMBUS AVE STE G5",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972234339",
            "telephone_number": "503-746-4740",
            "fax_number": "503-746-4740"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AGAPE HOSPICE & PALLIATIVE CARE NW, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-09-23",
        "last_updated": "2023-10-03",
        "certification_date": "2023-10-03",
        "status": "A",
        "authorized_official_last_name": "LOUKA",
        "authorized_official_first_name": "LARISA",
        "authorized_official_middle_name": "MIHAELA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "503-628-9595"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "16-1087",
            "state": "OR"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "admin@agapehospicenw.org",
            "affiliation": "N",
            "endpointDescription": "email address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "10200 SW Nimbus Ave Ste G5",
            "city": "Portland",
            "state": "OR",
            "country_code": "US",
            "postal_code": "972234339",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Agape Hospice NW",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Agape Hospice NW",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Karim Afzal, PH.D.
• Muhammad Farooq Afzal, MD,FRSCSED
• Agape Health Clinic
• Agape Hospice Care, Inc.
• Vratika Agarwal, MBBS
• Nicole Agazarm, LMT
• Osaretine Agbonze
• Prince Roland Agbonze

• Community Based Hospice Care Agency in Portland, OR
• Providers in Portland, OR by specialty
• Community Based Hospice Care Agency in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.